Provider Demographics
NPI:1003901760
Name:FRANK, MARYJANE (LISW)
Entity Type:Individual
Prefix:MRS
First Name:MARYJANE
Middle Name:
Last Name:FRANK
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 HILL RD N
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-1157
Mailing Address - Country:US
Mailing Address - Phone:614-834-1919
Mailing Address - Fax:614-834-1920
Practice Address - Street 1:437 HILL RD N
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-1157
Practice Address - Country:US
Practice Address - Phone:614-834-1919
Practice Address - Fax:614-834-1920
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00047841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000117264OtherANTHEM
OH9111115Medicaid
OH1125-01OtherMOUNT CARMEL BEHAVIORAL
OH1125-01OtherMOUNT CARMEL BEHAVIORAL